Organization
FOF OPTICAL PLLC
Active
Other names
The Optical Edge
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA MARIE JEZIORNY KEROUAC OD (OPTOMETRIST)
(708) 805-7618
Entity
Organization
Contact information
Practice address
372 LARRY POWER RD, BOURBONNAIS, IL 60914-5190
(708) 805-7618
Mailing address
1158 LAFITE, BOURBONNAIS, IL 60914-4538
(708) 805-7618
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
02/07/2025
Last updated
02/27/2025
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